I've written about health care for more than two decades, starting from my native Iowa where I covered the presidential campaign bus rides of Bill and Hillary Clinton through the Hawkeye state talking health reform and the economy. I have covered the rise, fall and rise again of health reform, chronicling national trends as well as the influence of Barack and Michelle Obama from Chicago's South Side on changes to the U.S. health system from my base in Chicago. I am the author of the new Forbes signature series book, "Inside Obamacare: The Fix For America's Ailing Health Care System." I was health care business reporter at the Chicago Tribune (1998-2011) and previously wrote for Modern Healthcare magazine when first arriving in Chicago in 1993. Prior to that, I wrote for several Iowa newspapers including the Des Moines Register. These days, I contribute stories to the New York Times, Chicago Medicine magazine and teach in the University of Iowa School of Journalism MA in Strategic Communication program. You can see me nationally on Fox News Channel's "Forbes on Fox" show. In Chicago, you can hear my health segments and business analysis on WBBM newsradio 780 and 105.9 FM. I am passionate about health literacy when it comes to explaining the complexities of health care. A better understood health system may save someone some money or their life.

Florida Gov. Rick Scott's Obamacare Medicaid Mea Culpa

Florida Governor Rick Scott has changed his tune and will now allow Florida to participate in an expansion of Medicaid health insurance benefits to the poor under the Affordable Care Act. Previously, Scott, a former CEO of HCA Holdings, said he worried about costs to the state if they expanded coverage despite the federal government picking up almost all of the tab. (Image credit: Getty Images via @daylife)

In a major about-face, it appears Rick Scott, the former hospital chain CEO turned Republican governor of Florida, will expand the state’s Medicaid insurance program for the poor under the Affordable Care Act after all.

Several news outlets in Florida and Washington are reporting that Scott has changed his tune and will go along with an expansion to cover more than one million people for the first three years, allowing a new governor to decide what to do after that.

Scott is now the seventh GOP governor to agree to expand Medicaid under the health law and “arguably the biggest political symbol of grudging Republican acceptance that Obamacare is the law of the land,” Politico reported tonight.

Earlier, Scott said he did not want Florida to participate in the health law’s Medicaid expansion partly because of what he believed are eventual costs to his state for increasing coverage. Under the health law, states have the option thanks to the Supreme Court decision in June to not to take part in an expansion of the number of people eligible to receive Medicaid.

“I cannot in good conscience deny Floridians to healthcare,” Rick Scott said at a press conference in Florida this afternoon.

Most states are going along with the Medicaid expansion given a cash infusion of more than $900 billion in federal dollars from 2014 to 2022.

This funding is unlike past efforts to expand Medicaid in that the federal government will pick up the full tab for the first three years. The state gradually has to pick up some costs in 2017 but by 2020 the federal government is still picking up 90 percent or more of the Medicaid tab.

It’s a much better funding proposition than the existing Medicaid program that essentially shares the cost between the states and the federal government. The federal government traditionally picks up a little more than half of the cost of Medicaid.

Until Wednesday, Scott had been the poster child among GOP governors who said they wouldn’t participate. Before he was elected Florida’s governor in the Tea Party wave of 2010, Scott was best known for running the giant for-profit hospital chain known as Columbia/HCA, now known as HCA Holdings (HCA).

When he was chief executive officer, Columbia became the center of a nationwide federal health fraud investigation in the mid-1990s, before settling for $1.7 billion over allegations the chain of hospitals fraudulently billed Medicare and other health programs. Scott eventually resigned under intense board pressure in 1997 as the investigation swirled around him.

Post Your Comment

Post Your Reply

Forbes writers have the ability to call out member comments they find particularly interesting. Called-out comments are highlighted across the Forbes network. You'll be notified if your comment is called out.

Yes, Darla was involved in his dismissal. That was quite the story back then and Tommy Frist was also involved in that departure. Two establishment Republicans took him out back then. Wonder if history will repeat itself in the next election?

my buddy’s mother-in-law makes $75/hour on the computer. She has been without work for 9 months but last month her payment was $20292 just working on the computer for a few hours. Read more on this site >>>>>>>>>> ℬing30.ℂℴm

Yes, we taxpayers will pay for Florida’s Medicaid expansion for the most part. But it will largely be dollars from federal coffers and not state dollars that Scott as governor of Florida has some control over. So he has some political cover, which he will likely use.

What isn’t mentioned here is that Florida was granted the power to put Medicaid into managed care before Scott flipped. Now, the federal money will go to the managed care company of the state’s choice before it goes to the Medicaid Fiscal Agent.

In a lecture to conservatives at the Las Vegas Country Club, Frank Fahrenkopf, co-chair of the Commission on Presidential Debates, admitted that the selection of CNN’s Candy Crowley to moderate the second presidential debate between President Barack Obama and Governor Mitt Romney in October 2012 had been a “mistake .” Now you tell us a__hole.

Imagine that !!! The guy who was involved in one of the largest Federal health care fraud, now Governor….Accepts Federal Health care money….good for the people who need it I just hope Gov. Scott keeps his hands off the funds…

“Most states are going along with the Medicaid expansion given a cash infusion of more than $900 billion in federal dollars from 2014 to 2022.”

Bruce, I cannot for the life of me see this ending well. States want to ditch the expense that as states they currently MUST pay, about half as you noted, of Medicaid and add it to the national debt that we currently cannot pay. It’s easy and politically rewarding to promise all this when you don’t have to actually come up with the money to pay for it. Free for three years – what a relief for the states. They can commit that money elsewhere and they will, just like people do. There will be no shift back to the states, they won’t have the money to do it. Ever.

By 2020, states would only have to pick up 10% which still leaves 90% going toward even more unpayable debt for current taxpayers and future ones – those who, by the way, are not recipients of any of this medical care and still have to buy their own ever more costly insurance on top of paying for others who may or may not live very healthy lifestyles.

Responsible people who actually pay taxes and try to live as good citizens of this country have become roadkill with birds of prey and other carnivores ripping them to shreds as they lie struggling to survive.

In all of this turn about Mr Rick Scott is doing, is this a bit of soul searching on his part regarding the Florida Constituants? Is Mr Scott worried that his initial plan might fall on deaf ears and effect the outcome of the election. At one time he was the Darling of the Teaparty, is this no longer the case.

Its to late to try to suck up to the Florida people now. You hurt this State when you became Gov. Not bringing in the high speed rail which would have help provide jobs for a while and help ease the traffic on I-4 from Tampa to Orlando. So what if we had to pay for it..we had to pay for you making millions of us anyway.

Yet another spineless politician caves to what’s popular and not what’s right to save his bacon. It’s all about getting re-elected and not proper governance. Obamacare will kill the economy and bankrupt this nation. The Federal government is over 16 trillion dollars in debt and spends like a drunken sailor. The sequester is the best thing to let happen in lieu of a real plan to cut spending. It should have happened years ago when it would have been less painless but politicians don’t do what’s right, just what’s popular.

cost the government(taxpayers) less to let everyone claim the subsidies in the healthcare reform law, because they would have to pay 2% of income premium and 6% of medical bills (actuarial 94%) states could repeal their current medicaid laws, if they would limit peoples premium to 9.5% of income if their income is over 400% of fpl ., wouldnt need medicare for people over 65. they should repeal the cost sharing subsidies and figure the premium credit on a policy with a actuarial value of 100%

If this turns out to increase the cost of living in florida I want out! I want all the money I invested in moving to a less costly none liberal state back. I did not endorse Rick scott and campain for him to be a liberal and increase the cost of living in florida. Many people come to florida to get away from states like california illinois and their ilk. Obama and the liberal mess we are facing now is way to expensive as it is. What have the liberals done for the people of the usa except doubled the price of gas and food? N O T H I N G! I am fed up with the fed! I am more fed up with suposed republicans acting more like liberals than republicans.